The first decision I had to make when I found out I was pregnant was which type of primary care practitioner (PCP) I wanted to see. Typically in Ontario, women see their family doctors; many of the doctors in our area also have delivering privileges at the local hospital. I’m fortunate enough to live in a city with a large team of midwives as well, so I was quickly faced with a pro-con list.

First on the list was my family doctor. I’ve been seeing him fairly regularly for the last ten years or so, and he’s got a general idea of who I am and the types of health concerns I’ve faced. His wait times are fairly short, and I knew that I could get an appointment within a few days if I needed one. The lab for bloodwork is right downstairs, and the ultrasound clinic is down the hall. It was convenient, close to home, and sounded like a good choice. The problem was that he doesn’t deliver babies. I could see him until 26 weeks, at which point I would be transferred to whichever OB in the area was accepting patients. I didn’t like that level of uncertainty; I’d much rather have someone who could follow me throughout my entire pregnancy.

My other choice was the midwives clinic. I would be assigned a group of three midwives to follow my case; with each appointment, I would see one of the three. There would be a midwife on-call 24 hours a day, reachable by pager, for any emergencies that might happen. Because the midwives are licensed, they could requisition any of the blood work I might need, and they have a great relationship with the ultrasound clinic in the building. If anything were to happen, they have a few OBs that they work with, so my care could be transferred and I could be seen by the midwives at the same time. They operate on the principle of informed consent; all of the tests, scans and treatments that are offered during pregnancy are carefully explained and detailed before they are done (or not done). They also encourage natural birth, either at home or in the hospital.

The problem with the midwives group is the transfer of care aspect. Say I went into labour and wanted an epidural; I would need to have my care transferred to the OB on call at the hospital, and the midwives would be done with my case. After following me for nine months, I would now be the sole responsibility of the OB and the hospital nurses.

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After having my pregnancy confirmed by blood test, and having a dating ultrasound at 10 weeks (thanks to PCOS, we couldn’t quite be sure how pregnant I was), I met with both my family doctor and the midwives. And though either choice could have been a good one, my anxious first-time-mom self was settled by the fact that the midwives spent over an hour with me, discussing what my hopes were for this pregnancy and birth. My family doctor, in comparison, spun the little due-date-calculator wheel, handed me a pamphlet on prenatal vitamins, and had his nurse take my blood pressure. In and out of the office in 10 minutes or less.

My choice to go with the midwives was one of the best decisions I could have made for my pregnancy. Each appointment was thirty minutes, and each time I heard baby’s heartbeat, learned something new about testing, ultrasounds, routine antibiotics or birthing methods, and felt genuinely listened to and cared for. Throughout excruciating SI-joint pain, major swelling of my feet and ankles, and morning sickness that just wouldn’t quit, my team of midwives made me feel informed, respected and taken care of. Despite the fact that they may have been up all night delivering a baby, they were always caring and positive at our appointments. I know the next time I see a positive pregnancy test, their office will be the first place I call.

(our incredible midwife, M, weighing Little Oats in our living room)

Did you have a choice for your PCP? Would you make a different decision next time?